J M Duggan1, A E Duggan. 1. Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, Australia. duggan@hunterlink.net.au
Abstract
BACKGROUND: For over a decade isolated reports have noted liver histology and biochemistry changes in patients with coeliac disease. The prevalence and response to treatment is clinically important. AIM: To outline the frequency and significance of liver abnormalities in coeliac disease. METHODS: A Medline search using Ovid-Coeliac/Coeliac (exp) and liver disease (exp) was completed of English references published during 1966-June 2003. Bibliographic references and other appropriate sources were also searched. RESULTS: Six studies reported liver biochemistry in 591 patients; 248 patients had abnormal results. Elevated transaminases were the most frequently reported abnormality. A gluten-free diet produced resolution of elevated transaminases in 115 of 130 patients. There was a greater than expected association with primary biliary cirrhosis and advanced liver disease. CONCLUSIONS: Mildly abnormal liver biochemistry is frequent in untreated coeliac disease and may provide a key to the diagnosis. Routine investigations for undiagnosed liver disease should include tissue transglutaminase testing. Left untreated, coeliac-induced hepatitis may rarely progress to end-stage liver disease. Primary biliary cirrhosis is clearly linked to coeliac disease. The full story of these linkages is yet to be written.
BACKGROUND: For over a decade isolated reports have noted liver histology and biochemistry changes in patients with coeliac disease. The prevalence and response to treatment is clinically important. AIM: To outline the frequency and significance of liver abnormalities in coeliac disease. METHODS: A Medline search using Ovid-Coeliac/Coeliac (exp) and liver disease (exp) was completed of English references published during 1966-June 2003. Bibliographic references and other appropriate sources were also searched. RESULTS: Six studies reported liver biochemistry in 591 patients; 248 patients had abnormal results. Elevated transaminases were the most frequently reported abnormality. A gluten-free diet produced resolution of elevated transaminases in 115 of 130 patients. There was a greater than expected association with primary biliary cirrhosis and advanced liver disease. CONCLUSIONS: Mildly abnormal liver biochemistry is frequent in untreated coeliac disease and may provide a key to the diagnosis. Routine investigations for undiagnosed liver disease should include tissue transglutaminase testing. Left untreated, coeliac-induced hepatitis may rarely progress to end-stage liver disease. Primary biliary cirrhosis is clearly linked to coeliac disease. The full story of these linkages is yet to be written.
Authors: Mathias Plauth; William Bernal; Srinivasan Dasarathy; Manuela Merli; Lindsay D Plank; Tatjana Schütz; Stephan C Bischoff Journal: Clin Nutr Date: 2019-01-16 Impact factor: 7.324
Authors: Alberto Rubio-Tapia; Ahmad S Abdulkarim; Russell H Wiesner; S Breanndan Moore; Patricia K Krause; Joseph A Murray Journal: Liver Int Date: 2008-04 Impact factor: 5.828